不规则抗体筛查在输血安全中的重要性分析

Importance analysis of irregular antibody screening in blood transfusion safety

目的探讨不规则抗体筛查在输血安全中的重要性。方法选择2012年2月至2014年12月凉山州中西医结合医院收治并拟接受输血治疗的1200例患者为研究对象。其中，男性患者为598例，女性为602例。输血前采用微柱凝胶技术对患者进行不规则抗体筛查，并对筛查结果呈阳性者进行统计相关分析。结果本组1200例受试者中，不规则抗体筛查结果呈阳性者为95例，不规则抗体阳性率为7．9％。本组女性受试者的不规则抗体筛查阳性率较男性显著升高（2．3％比5．6％），差异有统计学意义（x^2=17．1060，P〈o．05）；有输血史者的不规则抗体阳性率较无输血史者显著升高（2．8％比0．8％），差异有统计学意义（x^2=13．9586，P〈0．05）；有妊娠史者的不规则抗体阳性率较无妊娠史者显著升高（3．5％比0．9％），差异亦有统计学意义（x^2=18．5415，P〈0．05）。本组95例不规则抗体呈阳性者中，同种特异性抗体为66例，其中Rh血型系统为35例，Lewis血型系统为10例，MNS血型系统为21例；非特异性抗体为29例（冷抗体为10例，自身抗体为15例，药物抗体为4例）。结论在临床输血中，对输血患者不规则特异性抗体进行筛查，可以提高输血疗效，对输血安全起到至关重要的作用，值得临床应用推广。

Objective To study the importance of irregular antibody screening in blood transfusion safety. Methods From February 2012 to December 2014,a total of 1 200 patients who would accept blood transfusions in Liangshan Yi Autonomous Prefecture Hospital of Traditional Chinese Medicine Integrated with Western Medicine were selected as study subjects. Among them, 598 cases were male patients, and 602 cases were female. Before blood transfusion, micro-gel technique was used for irregular antibody screening of all subjects, and if their screening results were positive, they were further analyzed by statistical method. Results Among 1 200 subjects,95 cases were in irregular antibody screening positive, and the irregular antibody positive rate was 7. 9%. The positive rate of irregular antibodies in female subjects, subjects with history of blood transfusion, and subjects with history of pregnancy were significantly higher than those of males subjects, subjects without history of blood transfusion and subjects without history of pregnancy （x^2=17. 106 0, 13. 958 6, 18. 541 5; P〈0.05）. Among the 95 cases with irregular antibody screening positive, 66 cases were isotype-specific antibodies, including 35 cases of Rh blood system, 10 cases of Lewis blood system, 21 cases of MNS blood system; 29 cases was non-specific antibody, including 10 cases of cold antibodies, 15 cases of autoantibodies, 4 cases of drug antibodies. Conclusions In clinical blood transfusion, irregular screening specific antibodies can improve the efficacy of blood transfusion which plays a crucial role in blood transfusion safety. It is worthy of clinical application and promotion.